Endogenous antioxidant defences in plasma and erythrocytes of pregnant women during different trimesters of pregnancy.

BACKGROUND: To assess the antioxidant capacity of pregnant women in Ogun State, Nigeria. METHODS: The activities of total superoxide dismutase (total SOD), manganese superoxide dismutase (Mn-SOD), catalase (CAT), glutathione transferase(GST), aminolevulinic acid dehydratase (ALAD), and the concentrations of glutathione (GSH), were determined in the plasma and red blood cells of non-pregnant (n=20), normal healthy pregnant women during different trimesters of pregnancy (n=90), and pregnant women with pre-eclampsia (n=7). RESULTS: A 2-fold increase in erythrocyte CAT activity was observed in the pregnant women (p<0.05), while CAT activity in the pre-eclamptic women was not significantly different from control (p0.05). A 3-fold increase in plasma Mn-SOD was observed in the pregnant women including those with pre-eclampsia (p<0.05). ALAD activities in the first, second and third trimesters of pregnancy were 35, 51 and 55% of control, respectively (p<0.05), while in the women with pre-eclampsia it was 31% of control (p<0.05). Total SOD also decreased significantly in the erythrocytes of the pre-eclamptic women (p<0.05). Other antioxidants (GST and GSH) were not affected. CONCLUSIONS: Results suggest that oxidative stress is higher in pregnancy than in non-pregnant state. Our findings also suggest that while plasma Mn-SOD might play a significant role in detoxifying the superoxide anions produced in the placenta, the decomposition of hydrogen peroxide in erythrocytes is mainly due to CAT activity. Whether inhibition of ALAD contributes to the etiology of pre-eclampsia remains to be elucidated.

Effect of single administration of levonorgestrel on the menstrual cycle.

BACKGROUND: Levonorgestrel (LNG) 1.5 mg administered within 72 h of unprotected coitus is an established method of emergency contraception. Currently, there is some, although incomplete, knowledge about the mechanism of action. METHODS: We administered 1.5 mg LNG peri-ovulatory to determine the effects on serum gonadotrophins, estradiol and progesterone levels. Fourteen women were studied in a pretreatment and treatment cycle; eight women (Group A) took LNG 3 days before the expected day of ovulation, while 6 (Group B) took LNG a day before the expected day of ovulation. RESULTS: The women in Group A had a significant delay in their LH peak and onset of the next menses compared with their pretreatment cycles (26.4 vs. 39.1 days, p<.05). Those in Group B had no significant changes in the endocrine parameters but there was a significant shortening of the mean cycle length in comparison with their pretreatment cycles (25.1 vs. 20.2 days). CONCLUSION: Levonorgestrel 1.5 mg acts as an emergency contraception by delaying the LH surge and interfering with ovulation. It may also disrupt corpus luteum formation causing premature luteinization of unruptured follicles.

Fertility desires and intentions of HIV-positive patients at a suburban specialist center.

OBJECTIVES: To determine the extent of fertility desires and intentions of HIV-positive patients receiving care at a suburban specialist clinic and assess how these may vary by their sociodemographic and health-related factors. METHODS: Questionnaire-based interview of a consecutive sample of HIV-positive men (18-55 years) and HIV-positive women (18-45 years) who presented at the HIV clinic of the Center for Special Studies, Sagamu, Nigeria, between November and December 2004. RESULTS: 63.3% of the 147 studied participants expressed the desire for childbearing, even though 50.4% of them already had > or = 2 children. Respectively, 71.5% and 93.8% of men and women who desired children intended to have > or = 2 in the near future. Only 4.3% of those who desired children did not intend to have any. All 30 individuals who had no children intended to bear children in the future, and they constituted 32.3% of those who expressed the desire for childbearing. Multivariate logistic regression analyses of associated factors indicated that decreasing age, shorter time since diagnosis of HIV infection and nondisclosure of serostatus to current partner significantly increase the odds of desire for childbearing, while having no children and a poor most-recent CD4 count significantly increase the odds of intention to have > or = 3 children instead of 1-2. CONCLUSION: The extent of the fertility desires and intentions of these patients poses a threat to the preventive strategies against vertical and heterosexual transmission of HIV in this region. In view of their compelling desire for parenthood, it may be wise for caregivers to desist from the conventional systematic advice against pregnancy but, in addition to laying emphasis on the risks, provide adequate information on practicable reproductive options for HIV-positive individuals.

Nevirapine-related adverse events in a patient receiving a fixed-drug combination pill.

Nevirapine associated rash has been well described in the Caucasian population. With increasing access to antiretroviral treatment--especially a fixed dose combination--by people living with HIV/AIDS in developing countries, there is a need to emphasize the lead in doses of nevirapine. We strongly recommend a warning label on the bottle advising patients on the lead-in period and the signs and symptoms of significant rash.